Tuesday, February 14, 2017

Mending a Broken Heart: Take Three



(Pre Ablation #2)
                In April 2016 I wrote the blog, A Healed Heart detailing Levi’s heart condition, Wolff Parkinson White (WPW). If you want more backstory on his heart condition and how an elite athlete like him even found out about his problem, see my previous blog. After reading that blog you would think everything was healed and fine. I didn’t write about it at the time but unfortunately the surgery was not successful.
                To cure WPW the electrophysiologist puts a catheter in the femoral vein and/or artery of each leg and runs multiple wires into his heart. They map the heart and find the unwanted accessory pathway, the “bad” spot, the pathway that shouldn’t be there that basically can let the heart conduct in a way it shouldn’t. When they find the pathway they either burn the spot or freeze it. Burning is the most effective method. Levi was not a candidate for burning as his accessory pathway is located right next to his normal pathway. If the Doctor were to bump the normal pathway this could cause his heart to stop. When working with burning, the results are pretty instant. When doing the freezing technique, there is a little leeway. If you accidentally touch the good pathway it may stop the heart but so long as you don’t continue to freeze, the tissue can “thaw” and the patient will be fine. If the Doctor touches the good pathway and stops the heart and it can’t recover, the only thing left is a pace maker.
                The Doctor Levi is working with has never caused heart block (where you have to put a pace maker in due to an unsuccessful ablation) in his 30+ years of practice. We feel in good hands. When the Doctor did the ablation the first time he froze the unwanted accessory pathway. His heart rhythm did not show WPW. The Doctor waited hours to make sure it didn’t come back. Upon leaving the hospital Levi was cured.  
Recovery after an ablation is very minimal and Levi was back at work a few days later. While on shift, he went on a fire call. The fire wasn’t huge and was easily contained. Levi didn’t end up in SVT (supra ventricular tachycardia) but after every fire the Firefighters go into rehab where they get fluids, food, and rest. In rehab the Medics come and check everyone out. With his WPW when Levi exerts himself he will go into SVT. His heart will start beating really fast and it will stay that way, sometimes for hours after. Since he didn’t have to exert himself his heart rate was fine. He asked the medics if they could do a 12 lead on him anyways. He was curious if he was cured from WPW. The Doctor had him scheduled for an appointment a month post operation but Levi figured why not check early to see? As soon as they ran the 12 lead EKG the words WPW appeared. His heart sunk. Apparently, he was not cured. He called to tell me the news. I was bummed. We knew there was a small chance of his heart healing itself and the bad pathway coming back and unfortunately for Levi he was one of the unfortunate few.
                 He told his Doctor and at his next appointment the Doctor had him wear a heart patch again to see what his heart was doing. There was a small chance that they damaged the unwanted accessory pathway enough that it wouldn’t allow Levi to go into SVT when he exercised. After two weeks Levi mailed in his monitor and awaited the results. They were as we expected, his heart was still conducting in a dangerous way. After talking with the Doctor, they scheduled another ablation.
                Upon operating on Levi, the first time, the Doctor discovered his accessory pathway is bumpable. That means if the pathway is even touched, it stops conducting, making it impossible to map/see. During the procedure, the heart is still beating. Imagine trying to zap an exact, tiny area with a small tool you are using through a vein, that you are looking at on a screen, all while your target is moving.  Saying it can be tricky is an understatement. This happened during the first ablation and the Doctor waited a couple hours and the accessory pathway eventually came back and he ablated again. During the second ablation, the pathway was bumped and it did not come back. Since the Doctor had mapped his heart out before he ablated the entire area and then some around where he knew the accessory pathway to be. He said he went as close as possible to his good pathway, even touching it which caused his heart to stop momentarily but quickly recovered since the freezing technique has more leeway in this regard.  They again waited for hours and it did not come back. Upon leaving it looked as though Levi was cured. The Doctor called me and told me how the procedure went, including bumping the good pathway, and that he felt confident they got the area. But Levi being a unique case, only time would tell.
(Levi finishing a 5km race or as he calls it, his marathon)
                Shortly after the second ablation Levi was scheduled for a yearly physical. He requested an EKG to see if he was cured. And for the second-time post ablation the screen read WPW. This was very disappointing. The routine was the same. Levi went in for his post op appointment and had a heart monitor strapped to his chest to see how things were conducting. Levi’s had WPW for as long as he can remember. He never knew anything was abnormal with his heart since he didn’t have major symptoms (like passing out) and thought the way his heart beat after exercise was normal. He now realizes what he thought was normal post exercise was in fact his heart going into SVT. He isn’t an endurance athlete so always thought he just didn’t recover as quickly after strenuous exercise due to being an anaerobic athlete.  I remember going on a hike with my family and Levi up the Grand Teton and my Dad hanging back with Levi as he was having a hard time recovering. We would take breaks and continue on our way feeling good but Levi would need more rest. My family and I are all endurance athletes so there was a little teasing on the part of Levi being a big muscular athlete who couldn’t keep up with the skinny distance runners. It was all in good fun but looking back we now realize he was suffering in SVT. I can’t imagine trying to exercise and having my heart rate stay well above its max for an extended period of time. No wonder endurance sports have not been his forte.
(At the top of Mailbox Peak, most likely in SVT, doing hand stands. 
If this is him with a heart condition,  
it's scary to think what healthy will look like!)
                After his second ablation Levi did hard track workouts, a track meet, and had a commercial fire that pushed his body to the max. He didn’t need to wait for what he already knew. The WPW wasn’t cured. He now knew what SVT felt like and he was definitely still having it. While on shift, he went on call for a commercial fire. Levi was working hard during this call. He sweated so much, the heart monitor patch came off. When he went into rehab the medics came over and took his pulse. His heart rate was high. Levi explained his situation and even showed them the heart patch the Doctor had put on his chest. The Medics said they still had to evaluate him per protocol so strapped a 12 lead to him. They saw WPW, which was expected, and that he was in SVT. The Medics told Levi to bear down. They wanted him to flex and hold his breath as sometimes this can get your heart out of SVT. Unfortunately for Levi his heart rate went higher, soaring to 217 bpm.
(Being evaluated by Medics post fire in SVT)
                The Medics put him in their rig and called the hospital for medical direction to see if converting him with adenosine would be acceptable to do. The drug is designed to stop your heart. Since Levi was already working with a heart doctor and this is what they would do to convert a regular patient the hospital said it would be acceptable to do. The Medics put an IV in Levi’s arm and administered one does of adenosine. It didn’t work. They doubled the dose and did it again. They told him to stay calm and take deep breaths as it can freak people out when their heart stops. When his heart stopped, Levi said he felt heat and pressure all over his body. It stopped his heart for 5-6 seconds. It worked. His heart restarted and immediately dropped from 140bpm to 90bpm in an instant. He said he felt amazing. He later recognized the feeling when his heart stopped as suffocation. Like if you dove deep under water and struggled to get to the surface before running out of air.
                The elctrophysiologist had a lot of good data after the heart monitoring and just as expected he was still in SVT. At his next appointment, the Doctor discussed the option of medication. The reason they hadn’t gone that route is because Levi’s heart rate gets very low at night. During monitoring, it would drop as low as 21 bpm. Since the medicines can slow your heartrate they would not be an ideal option. Levi wondered what would happen if the drugs made his heart rate go too low at night? How would he know? The Doctor said they would keep him over night in the hospital for a night or two in case his heart rate got dangerously low. He talked with me about the options and neither of us liked the drug option. He emailed his Doctor with questions about doing another ablation and was relieved to find out the Doctor was completely fine with doing another ablation. Sometimes patients want to see results and don’t want to continue doing surgical options without result. Since Levi was fine with going in as many times as the Doctor saw fit they went ahead and scheduled another ablation.
Levi’s Doctor brought up his case with his other colleagues and after discussion, he decided he is going to try and go in from the left side of Levi’s heart. Ablations are typically done going in via the right side. The left side is a different approach for his condition. There is a slightly higher risk of a blood clot traveling to the brain since the left side of the heart has arteries that lead to the brain. The Doctor will give Levi a blood thinner to lessen the risk.  Levi’s accessory pathway is in the wall that separates the two sides of the heart so the Doctor may be able to access it from the left side of the heart. The Doctor will go in and first map the area to see if there is a window of opportunity to get to the area. If there is they will ablate, if not, he will pull out and we will go from there and see what options we have. 
For some inspiring and uplifting thoughts, I’m resharing a video of Levi vaulting. I love this video. It was taken while Levi was wearing his heart monitor after his second ablation. After his doctor reviewed the data he saw that Levi was in SVT during his vaults and there was a marker where a button on the monitor was pushed. The button is used to mark when you feel something weird. It got pushed when Levi’s friend tackled him onto the pit in celebration. The video shows the clutch vault that Levi took that qualified him for the 2016 Olympic Trials. Levi took a risk, on his opening height he put the bar at a PR (it is very rare for anyone in pole vault to open at a PR), and on his third attempt made it. Let’s hope the third ablation attempt will yield the same result. I have faith.

Monday, June 20, 2016

Making up My Mind




(Bear Run 5k)
You would think after 9 months I would have somewhat of an idea what I want to do athletically. But the truth is I have no clue. In 2012 I had a plan. Make the Olympic Trials, start trying to have a family, get back into racing shape and race locally. Check, check, and check. After the birth of my second I didn’t have a plan. It was another Olympic year but that was very unrealistic for me. So, what next? I decided to give myself all the time in the world to decide and I took it. My husband, Levi, and I talked about him going for another Olympic Trials in the Pole Vault. We knew realistically that we both couldn’t be pursuing big athletic goals or else our family life would suffer. I encouraged him to go for it and enjoyed my time on the sidelines chasing after kids. But there comes a point when things can begin to get too comfortable. Where the day in and day out of easy running becomes habit and the motivation for anything bigger dwindles.
(Almost a year after my 1st baby, competing at Club Nationals)
After I had Lily in 2013 I came back to racing in 2014. I did local meets and definitely didn’t put in the same workload as I had prior but it was enjoyable and not too taxing. Well, in the beginning I think it might have been as my weight dropped 7 or so pounds below what I normally am. I lost muscle and with breastfeeding was leaning up quickly. I never became iron deficient but made it a goal to eat more and lift more. Check and check.
Okay so where does that leave me in 2016? The original plan was for Levi to focus on track while I focused on the kids and home life. Once his track season was over, I would pick up my training and start racing more. Well it is now the end of June. Track season is coming to an end. And I’ve gotten too comfortable these past 9 months not getting out of my comfort zone. The desire to actually start a training schedule does not sound appealing to this new comfortable me, but there are moments when the old me tries to claw its way out of this life of ease.
(Prior to kids.)
Now don’t get me wrong, when I say life of ease, I’m not talking giant inner tube, lazy river, sipping a cold drink in the sunshine. My days are exhausting but in a different way. By the end of the day mentally, I am spent. Yet I stay up way too late simply to enjoy doing nothing (i.e. watching TV or something). Most days I feel like I’m going nonstop to accomplish what would look like nothing on the outside. Feeding, diapers, laundry, grocery shopping, cooking, cleaning…Just normal life. But with two little ones it takes forever most days. If I want to get anywhere on time I need to start preparing an hour and a half before we leave. Add another half hour if where we are going requires sunscreen. But when it comes to working out I am not pushing my body like I used to. Nine months of easy running makes you pretty comfortable running short and easy. I don’t have any daily running plans and in a way that can be nice. I don’t want my training schedule to dictate our lives. In 2012, I like to think I was flexible but there’s no way I would have been able to do what I did with kids. I had my workouts, races, and lifting schedule written out every day. Sure there were times I would do an unplanned wake boarding day but it was never on a hard workout day and I never missed my run because of it. I just ran at a different time than usual. If we want to go to the lake on a moment’s notice now, I don’t feel stressed about getting my workout in prior. As I’m merely running because I like to run and some days I don’t feel like it. Some days I just want to sit on the couch and eat ice cream. I’m able to enjoy life as it comes.
(Impromptu lake day)
But the point of this is that there is still a gnawing inside me that I should be, that I need to be doing more. I am fine right now but there is a fear that this will become too comfortable and soon I will find myself becoming lazy. When I lift hard and am sore the next day I relish that feeling. Even if squats make it hard for me to walk down the stairs I enjoy that. I’m using the one body God gave me. I’m still young (though most days I don’t feel it with kids) and I want to set myself up on the best path later in life. I want to be a role model to my girls. Not a, “Back when Mom was young she could blah, blah, blah.”
So that brings me to flipping through the paper a few weeks ago and coming across an ad for a race 15 minutes from my house. I checked Levi’s work schedule. He wasn’t scheduled. So what was the excuse? Immediately I felt nervous and excited just thinking about racing. It was two weeks away. No time to train specifically for it but I’ve always enjoyed racing so why not? Thoughts of winning crossed my mind, my old self clawing its way out again, but Levi, always the voice of reason, helped throw this thought out. Who cares if I won or not? Who cares if I don’t run “fast.” I say “fast” because I know it is all relative. My slow might be someone’s fast and my fast might be someone’s slow. I wasn’t doing it to prove anything to anyone. I was doing it for me.
I got online and signed up for the Bear Run 5k at Lake Wilderness. The next day I immediately got on the treadmill to see if I could run a 5k under 20 minutes. I did a little warm up and started going. With half a mile to go I had to decrease the incline from 2 to .5 it was getting hard. I was hot. It was tough but I mentally held out even though I knew I could stop at any time. I did not want to let comfortable Lois win. I broke 20 minutes. I finished my treadmill 5k in 19:32. Alright I should be able to break 20 minutes in the race. I don’t know why I even cared about my time but having a goal might keep me honest out on the course. I finished my workout with a cool down jog making it 7 miles on the day and my longest run post baby #2.
I did a few 200 meter strides during another treadmill run that week and that was my prep for racing. The night before my race soon came and Levi and I made a tentative plan to have him meet me at the race with the kids so they didn’t have to get up so early. I made a goal to get to bed earlier than I usually do but somehow ended up getting to bed even later…definitely past midnight. I didn’t stress about missing sleep. I’ve been missing sleep for the past 2.5 years so what’s another night?
In the blink of an eye, my alarm was sounding at 6:10am. One snooze push and I was up. I didn’t feel like making oatmeal so I ate a piece of toast with jam, hardboiled egg, and a granola bar for the short drive over. Eve had been waking up around 6:30am the past few days so it would work out perfectly to nurse her then head over just after 7am to get my number. 7am rolled around and still no peep from Eve. I opened her door. A few minutes later I came back and opened her curtains a little. Finally she woke. I tried to nurse her but she decided she didn’t want to. Trying not to get frustrated I waited. Soon hunger kicked in and she got to work. There’s no way I would have raced without at least pumping and I really didn’t want to get my pump out of the closet and do that. I really didn’t have the time and I doubted she would take a bottle anyways. I ended up leaving 40 minutes later than planned but since I know kids are unpredictable I also prepared for something to come up to make me leave later. No stress.
I got to the race and found some free parking. I had no idea this was a part of a big festival weekend complete with carnival rides. Check in to get my packet was easy. I headed off to warm up. I felt terrible. I rarely run in the morning and my body was feeling it. My legs felt like led. I did some drills to help loosen up but it didn’t really seem to help. I figured once the race started I wouldn’t notice.
(Levi and the girls before the start)
Levi and the girls made it with plenty of time before the start and I had fun playing around with them. It’s amazing how relaxed racing becomes when you have kids to distract you. They put everything into perspective. I saw some of the master’s men runners from Club Northwest so it was nice to see some familiar faces. I found out from a few their goal times and knew not to go out with them! They are legit master’s runners.
The first mile was relatively flat with a climbing hill at the end and into mile two. My legs hated the hills. Just under two miles the course entered a flat trail. I felt good. But I didn’t really push too much as I was unsure what I was capable of. Maybe I wussed out a little, I’m not sure. I passed a young boy. He gave me encouragement. I replied in kind. About a half mile from the finish he comes blowing by me telling me good job again. I manage to wheeze out a compliment and watch as the boy, who maybe came up to my shoulder, went sprinting to the finish. I dug deep and turned my legs over faster. I crossed the finish line in 19:24. Good for first place female finisher, which meant a Teddy Bear and some cupcakes. Lily was quite happy about my race spoils.
(Top 3 women in my age group)
(Post race, nursing Eve)
I must admit, the race hurt. It was a pain I hadn’t felt in a long time, but I didn’t hate it. In fact, I sometimes feel it hurts worse when you are unprepared or out of racing/workout shape. It had been so long since my body experienced this type of pain that I forgot what to expect. I hadn’t done grueling workouts, pushing myself out of my comfort zone day in and day out. So when I was out of my comfort zone in the race it was a bit of a shock to my system. If you are truly pushing yourself it hurts the same no matter where you finish. Whether you are the elite running record times or the weekend warrior, racing hurts. But the sense of accomplishment after, the burn in your lungs and legs that scream out, “I’m alive!” makes the pain something you will continue to come back to. So to you beginner runners, I feel for you. I can see why some don’t like it. But I can assure you it gets better. Or maybe it doesn’t, you just get used to it.

Sunday, April 3, 2016

A Healed Heart

            My husband Levi, had heart surgery.
This sounds pretty intense and crazy to believe for a healthy, young, and very fit man, but it’s true. But not as scary as it might sound, or maybe I’m na├»ve. With the technology available to us today it is amazing that he could have “heart” surgery that he didn’t feel afterward and was up moving around as soon as the anesthesia wore off. The next day the only signs of the procedure were the sticky residue left behind from patches stuck to him for monitoring. He was out mowing the lawn in the beautiful sunshine and working on a fence he built.
(Beautiful fence Levi built)
                Now to catch everyone up to speed: Years ago, while we were living in Idaho, Levi had a nose operation to try and correct a severely deviated septum. He couldn’t even breathe through his nose. When he woke from the surgery his heart rate was in the 30s. This freaked the nurses out. We tried to assure them that it was due to his genetics and being very fit. He had hernia surgery shortly before this with the same nurse attending but the sports Doctor who knew Levi, was not at all concerned with his low heart rate. But this time the nurse wouldn’t be swayed. They called for an ambulance and had him transferred from the surgery center to the hospital for testing.
(Post nose surgery on his way to the hospital. Funny years later he would be working on the other side of the gurney.)
                He was strapped to an ECG machine and it immediately picked up Wolff Parkinson White (WPW) syndrome. WPW is basically an extra electrical pathway that can affect the pacing of the heart. This was the first time we had ever heard this so we were a bit concerned. He was referred to a heart specialist and in the end since he had never had a symptom, the Doctor said he wouldn’t do anything about it yet. He did caution Levi that being an athlete, he might be excluded from certain competitions (like the Olympics) due to his heart condition and it being risky. The Doctor was surprised Levi hadn’t had any ECG’s before especially being a Division 1 college athlete. I think testing every athlete’s heart should be mandatory to compete in college athletics. It just might save a life for those with a serious heart condition. We took the information and continued on with our lives, pretty much forgetting he even had it.
(WPW heart pattern)
                Fast forward to 2013, Levi submitted a video and was selected to take part in American Ninja Warrior. He traveled to Venice Beach to compete and advanced to the finals in Las Vegas. We were excited. He traveled down earlier for filming and I a bit later. On my way down I received a call from him. They were doing ECG’s on all the competitors. He sounded worried. WPW was back fresh in our minds. The Doctor strapped Levi up and checked his heart. He then began asking Levi a series of in depth questions. Levi answered honestly but knew why he was being asked. The Doctor finally gave him the go ahead to compete, since he was asymptomatic.  
(American Ninja Warrior 2013)
                In 2014, the gym where Levi and I worked at closed its doors for good, but three days earlier Levi officially started his dream job as a Firefighter for the City of Tukwila. He had applied well before he knew the gym was closing so the timing could not have been any more perfect. God’s hand was definitely in that one. We were excited for the opportunity. He passed all the physical tests no problem. Then there was one last thing, the ECG. There it was on the screen, WPW. The Doctor asked Levi about it and he told him he knew he had it. He went on to explain his history, Doctor visits to specialists, and never having a symptom. The Doctor asked Levi more questions and eventually cleared Levi fit for work. Being an elite athlete helped as he had tested his body time and time again in grueling practices and workouts and never once had a symptom.
(Levi Keller in his Class A's)
                Then in 2015 Levi got his first structure fire. He was pumped. He was battling the blaze in a walk out basement. He threw things out of his way, sprayed and moved piles of burning material, and stomped through debris. He was on fire…er, well he felt unstoppable. He was on the nozzle dealing with an inch and three quarter line with a lot of pressure, inside tight spaces, knee deep in debris, or in lay terms, he was working very hard. After the fire was out, he went through gross decon (they spray you with a hose to get the big stuff off) and went into rehab (where you rest, eat, and drink). He was moving around, eating snacks, drinking water, and feeling pretty stoked about his first fire. The Firefighters got checked out by EMT’s 10 minutes after getting in recovery. An EMT came over to Levi and checked his pulse and blood pressure. His heart rate was abnormally high. He thought he must have messed up so took it again. It was still very high. He called a Medic over. The medic took his pulse and got the same reading and put a 4 lead on him. It showed 192 beats per minute. He went to get the 12 lead. Oh no, was all Levi could think when he saw it. He knew what the machine would say. He told the Medic to hang on a second that he was just really excited after his first fire. He took a few deep breaths and got his heart rate down to a reasonable heart rate (in the 80s). The Medic didn’t like that either. That wasn’t normal. So they put the patches on and sure enough WPW came on the screen.  Levi told the Medic he knew he had the condition and that he had seen several Doctors and was cleared. The Medic wasn’t convinced and needed to follow protocol. As a courtesy he told Levi he could walk to the ambulance instead of going via gurney so as not to draw attention. However, as they pulled out, the guy driving turned on the sirens and took off, so much for leaving quietly.
                If I had to put this in perspective it would be like finishing a steeple race. Crossing the finish line, drinking some water, walking off the track, back through the marshaling areas, sitting at my bag, eating a granola bar and still having my heart as high as in an all out sprint held at the very end of a race.  
(Training)
                Levi was transported to the hospital where he had to stay for a few hours. They did an EKG and it showed he had WPW. They also did blood work and found he was very dehydrated, which is to be expected after fighting a fire and leaving the rehab area. They gave him two bags of fluids to fix that. The cardiologist came in and talked to Levi. He told him that he wouldn’t be cleared to go back to work until the next cycle. He also recommended that he set up an appointment with an electro cardiologist. The electro cardiologist did an EKG and asked Levi a bunch of questions. Levi asked if it would be possible to get a Doctor’s note to have on him at work so if this happened again he would not have to miss work and be transported to the hospital. The Doctor said he wouldn’t do that without doing more tests but that he thought it was reasonable. They talked about doing an EP study, where they map the heart and test its pathways. In the meantime Levi got a second opinion and the Doctor concurred with the original Doctor. Levi set up an appointment for an EP study with the intent to ablate. An ablation is a surgical procedure to burn or freeze the unwanted pathway via a catheter inserted in each leg. They wouldn’t know until they did the EP study if they would be able to also ablate the accessory pathway during the appointment without seeing where the accessory pathway was. It is rare that the accessory pathway is right next to the good pathway which would make an ablation too risky to perform.
                Levi was mostly awake during the procedure and during it found out that he is “unique.” His accessory pathway was right next to the good pathway and the Doctor did not want to attempt the ablation. Since Levi was asymptomatic the risk didn’t seem worth the possibility of the procedure causing heart block meaning Levi would need a pace maker for the rest of his life. The Doctor decided to monitor his heart for two weeks with an external monitor taped to Levi’s chest. Oftentimes they do this first but in most cases if you are asymptomatic it won’t show anything that you don’t already know and going in to ablate is usually a simple procedure.
                We were in MT visiting my family about the time the Doctor called Levi with the results. Levi hung up the phone and I asked what he found out. He responded, “Basically everything that could be bad is.” During the monitoring Levi was in fact having “symptoms.” He wasn’t feeling them but his heart was trying to go into SVT. It was trying to conduct at 250 bpm. Not all of the beats were going through, luckily, but it was getting in the high 190s. For some reason Levi never felt any of this. Maybe it was happening during workouts and he was attributing it to working out hard. Who knows? The next option would be taking medicine to treat his condition. But during the monitoring they found Levi’s resting heart rate to be extremely low. It measured 21bpm at the lowest! The low heart rate was not a concern it’s probably part genetics, part fitness. But due to such a low heart rate the option of taking a pill that would lower his heart rate even more was off the table. So now the only option was an ablation. At the time this didn’t seem like a great option since the first time they went in they found his accessory pathway to be in a very hard spot to operate on. Levi would meet with the Doctor in person to discuss things further. In the meantime, he had his Doctor also send the results of his monitoring to his second opinion person.
                The second opinion concurred with the first Doctor again saying that after looking at his two week heart study he felt an ablation was definitely needed.  Levi had his appointment with his first Doctor and discussed the option of simply waiting. As you age, the symptoms can get worse but the odds of Levi’s first episode being fatal were low. Levi had a long refractory period which meant his heart had less of a chance of conducting in a bad way that could be fatal. The Doctor told Levi there was a surgeon in Oklahoma that took the really hard cases. He didn’t think Levi was to that point yet. He wanted to do go in to ablate it while using a more precise mapping instrument. The mapping tool the Doctor used on the first EP study is what is typically used as cases like Levi’s are rare and the reason for not using the other tool is cost. The other instrument is over $30,000 more.  The Doctor had never caused heart block in a patient in his 30+ years of doing the procedure and he wanted to try Levi’s but ultimately was leaving it up to him. He told Levi if he opted to wait until he was older to have an ablation he couldn’t in good conscious recommend him to be a firefighter. In his profession the risk is too great of having an episode become fatal. Like if Levi was to have a symptom and pass out during a fire. Levi took some time to think things over.
                In the end he decided to schedule the ablation. There are two options for ablation, a burning and freezing technique. They chose to do a freezing technique. This way if they accidentally touched the good tissue they could simply wait for it to thaw back out and not cause heart block. If you burn it, it is permanent meaning the good tissue cannot come back and you end up with a pacemaker. It would take several freezes on the accessory pathway to stop it from conducting and there was no guarantee they would be able to get it all.
               
(Levi and my brother John, who made the day of
Levi's procedure easier)
March 30th Levi went in for his procedure. It was hard figuring out what to do at first with the kids. His check in time was at 6:30am. In the end Levi drove himself to the University of Washington and parked there. The plan was for my brother to take the light rail from downtown Seattle to the hospital after he got off work and drive Levi in our car to his house where Levi could stay and rest. This made things a lot easier. I try to be optimistic about things like this but for some reason leading up to his procedure I was expecting the worse. I didn’t tell this to Levi and kept it to myself but I could read doubt from Levi as well. I figured they would go in, say they couldn’t perform the procedure and we would have to figure out what options were next. A trip to Oklahoma perhaps? During breakfast as Lily, Eve, and I sat eating our oatmeal, I looked at the clock. It was just after 8am. Levi was scheduled to be starting his procedure. I stopped and said a prayer out loud and realized that by preparing myself for an unsuccessful surgery I was lacking faith. I talked to God and told Him I had complete faith in the outcome. For once, I was feeling optimistic about it. Yes, I prayed for a successful surgery but ultimately I prayed for God’s hand in this, whatever the outcome. If the news was anything otherwise we would go from there. I felt much lighter finally surrendering and giving this to God. I know it seems so small but until I let it go I didn’t realize the weight it had been on me. There was nothing I could do. WPW was something out of Levi’s control, he didn’t do anything to cause it and the outcome was out of my control. It was God’s and God’s alone. But even in a small way it opened my eyes to surrendering to God and how often I hold back in my day to day life without realizing it. This was a good reminder.
                I talked to Levi shortly after his procedure but things were a bit fuzzy. He told me they thought it was a success but that he had to have a follow up to make sure. He had been knocked out for 5 hours and had received 500 mcg of Fentanyl and some (10) Versed which apparently is a lot! Levi remembers them injecting him and not getting knocked out so they did some more. When he was more alert I got more accurate details. The procedure was a success! At one point the Doctor sat and watched his heart for 40 minutes after freezing the accessory pathway because it looked like the accessory pathway was still trying to conduct. It didn’t. Before he left the hospital they did another ECG on him and for the first time in Levi’s life the letters WPW did not show up!
(Looking pretty good the day after heart surgery)
                The Doctor told him it was a tough procedure, one of his most challenging. He said he really prepared for this one. He got up and got his exercise in before 5am to get his mind and body ready. I definitely have respect for a Doctor who uses exercise to prepare for his work! Levi will go back in for a follow up but the Doctor said after watching his heart during the procedure and having a normal ECG he is confident he is cured and the accessory pathway won’t be able to conduct any more.
                It is strange to have Levi “cured” of something he never even exhibited symptoms of. How he originally only found out he had it by accident as a result of being a fit individual with a low heart rate.  It is amazing the technology we have today, that Levi could get heart surgery via his veins near his groin in each leg and the biggest possible risk being bleeding at the insertion site. He said it was like getting an IV, only a slightly larger tube and in your leg not your arm. The day after his procedure he was out working in the yard. The sun was shining, the girls were out playing, and I couldn’t help but smile watching him work. Who would have thought three little letters could make such a difference? Though our lives seem unchanged and will go on as they always did, under the surface, everything is different and that is why I smile. 

(Out playing while Dad works)